In the fight against malaria, it’s not just about mosquito nets

The Ministry of Health, in collaboration with donor countries, is working with local volunteers to both distribute mosquito nets and educate the public on how to use them correctly. Photo by Blantyre News Limited.

The World Health Organization (WHO) announced in October that nearly a third of all countries affected by malaria are on the path of eliminating the mosquito-borne disease over the next 10 years.

Malawi is one of them.

Elimination, of course, depends on whether or not current efforts are sustained.

But due to flaws in the country’s healthcare system and, more recently, given the fragility of the global economy, it seems that the fight against malaria is likely suffer a few setbacks in this country.

According to the Global Fund (GF), which is an international initiative against malaria, tuberculosis, and HIV and AIDS, approximately 95 percent of Malawi’s population of 14 million, is at risk of malaria infection. Two groups are particularly vulnerable to the disease: women (51 percent of the population) and children under the age of five (17 percent).

But malaria isn’t just a severe public health problem; it also has a direct impact on the country’s economic and social development.

The Ministry of Health reported that there were over six million malaria cases in 2010. Economically speaking, this means that the country’s workforce lost between 15-25 days of productivity due to malaria alone.

Furthermore, most families spend about 28 percent of their yearly income (approximately CAN$170) to treat it.

Still, experts affirm that progress is being made in Malawi.

The Ministry of Health, with the support of the GF and the President’s Malaria Initiative (PMI) from the United States, have since 2005 distributed across the country insecticide-treated, non-toxic mosquito nets, which have proven to be highly effective when it comes to reducing transmission of the disease, as they can kill mosquitoes for up to three years.

And according to the Ministry of Health, Malawi has seen a 50 per cent reduction in malaria transmission ever since.

Global statistics confirm this positive trend.

The latest report of the United Nations and World Bank supported-initiative, Roll Back Malaria (RBM), reveals that malaria deaths have dropped globally by an estimated 38 percent in the last 10 years, with an impressive 43 out of the 93 countries identified and included in this initiative – including Malawi – cutting malaria cases or deaths by half.

Wanting to continue with this success, Malawi’s Health Strategy Plan for 2011-2016 places malaria’s reduction as a top priority, along with HIV and AIDS.

However, Malawi’s generally underfunded and fragile healthcare system, and the uncertainty of any future external funding from the GF, and donor countries including the United States, the United Kingdom and other European countries, due to the world economic crisis, threaten to make those achievements accomplished so far moot, while putting at risk the implementation of future initiatives and programs.

The Global Fund announced in September that it has halved the estimated amount of money available in its next round of funding, from US$1.5 billion to US$800 million, the disbursement of which has been delayed until 2013.

This is worrisome as the Global Fund accounts for two-thirds of the malaria, tuberculosis and HIV and AIDS response in Malawi, and the balance comes from the donor countries. Malawi has been assured of Global Fund money until about June 2014 but has been warned to look for sustainable financial models to continue its programs.

And while Malawi’s National Malaria Strategic Plan has stated its aim to have 60 percent of the country’s health centres equipped to perform diagnostic testing for malaria, the Global Fund reports that Malawi is far from achieving this goal.

And even where diagnostic testing is available, both laboratory staff and hours are limited, with some facilities seeing more than 200 cases of potential malaria cases each day.

These studies also show that more than half of the patients that tested negative for malaria were still prescribed antimalarials, suggesting that health workers have very little confidence in laboratory test results.

When it comes to malaria in Malawi, significant gains have been achieved and lives have been saved; but without sustained financing to consolidate these accomplishments and enable the continuation of initiatives for malaria treatment and against its transmission, the progress that has been made may quickly backslide.

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